Gall Blader

Gallbladder Cancer

Treatment

  • There are two types of surgeries for gallbladder cancer:
    • Potentially Curative Surgery for resectable tumors
      • Open cholecystectomy - removal of the gallbladder is called a cholecystectomy. Usually an open cholecystectomy is preferred for gallbladder tumors.
      • Extended (radical) cholecystectomy - In more advanced tumors, the gallbladder along with a wedge of adjacent liver tissue and regional lymph nodes are removed totally.
      • Multi-visceral/ Liver resection- In certain advanced gallbladder cancers when the tumor has spread to adjacent organs including the liver, resection of the gallbladder tumor along with involved organs like liver, duodenum and colon may be done. Such advanced surgical resections are done only in selective patients by highly experienced surgeons.
    • Palliative surgery to relieve symptoms in unresectable tumors- In certain advanced cases of gallbladder cancer causing gastric outlet obstruction or bowel obstruction, a bypass procedure may be suggested.
  • This treatment uses high-powered energy from sources such as X-rays to destroy cancer cells and shrink tumors. Doctors carefully direct the energy to the tumor, while sparing the surrounding healthy tissue.
  • Radiotherapy is given before surgery to shrink the tumor and makes it easier for surgical excision. External beam radiation therapy (EBRT) uses high precision techniques likeIntensity Modulated Radiotherapy (IMRT), Image Guided Radiotherapy (IGRT) and Volumetric Modulated Arc therapy (VMAT/Rapid Arc) are useful in targeting the tumor accurately and avoiding normal tissue injury.
  • When the cancer spreads to other organs like the liver a special technique called Stereotactic Body Radiotherapy using CyberKnife or Linear Accelerator can be used to treat these conditions.
  • Proton therapy is a modern Radiotherapy technique in which gallbladder cancers can be treated successfully with minimal radiation dose to the surrounding normal tissues.
  • Chemotherapy drugs are cytotoxic drugs that kill cancer cells. In gallbladder cancer they play a role after surgery and in advanced disease. The choice of regimen depends on the general condition and fitness of the patient.
  • Immunotherapy- In recurrent or progressive disease, chemotherapy and immunotherapy options are possible. Immunotherapy is a drug treatment that uses the immune system to fight cancer. The indication for immunotherapy is based on immunohistochemical tests and molecular tests in advanced disease and recurrence. Further therapy options are decided based on the genetic profile of the cancer
  • Palliative Therapy - This helps to relieve symptoms such as nausea, pain and other symptoms caused by advanced cancer. Radiation, chemotherapy or surgery may also be done to help relieve symptoms caused by cancer.
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